More vitamin D commentary
26/12/10 14:01
More recent commentary on vitamin D as covered by Natural Medicine Journal:
Let the Science and Evidence Guide Clinical Decision-Making on Vitamin D for the Benefit of Patients, Alexander G. Schauss, PhD, FACN
This article discusses biochemical individuality, as well as evidence in favour of vitamin D as relates to frailty in elderly populations, genetic and racial variations, and immune support. Ultimately, he reiterates that we must “consider the individual,” which is what naturopathic medicine is all about!
Broad-Brush Recommendations Are a Disservice to the Public, Geovanni Espinosa, ND
This article summarizes conditions associated with vitamin D deficiency and provides some broad intake recommendations.
Media Coverage Further Confounds Recommendations, Susan W. Ryan, DO
This article highlights one major issue plaguing media coverage of health issues - inaccurate or incomplete reporting. Unfortunately, as a naturopathic doctor I find this to be all too common! What gets covered in major media is not necessarily representative of the information that exists on a topic, it is slanted more towards what is strange/interesting/controversial/trendy. This also includes such information available on the internet. There is a lot of great information to be found on the internet, but your best bet is to find out what is best for YOU from a trained health professional, such as your naturopathic doctor.
Let the Science and Evidence Guide Clinical Decision-Making on Vitamin D for the Benefit of Patients, Alexander G. Schauss, PhD, FACN
This article discusses biochemical individuality, as well as evidence in favour of vitamin D as relates to frailty in elderly populations, genetic and racial variations, and immune support. Ultimately, he reiterates that we must “consider the individual,” which is what naturopathic medicine is all about!
Broad-Brush Recommendations Are a Disservice to the Public, Geovanni Espinosa, ND
This article summarizes conditions associated with vitamin D deficiency and provides some broad intake recommendations.
Media Coverage Further Confounds Recommendations, Susan W. Ryan, DO
This article highlights one major issue plaguing media coverage of health issues - inaccurate or incomplete reporting. Unfortunately, as a naturopathic doctor I find this to be all too common! What gets covered in major media is not necessarily representative of the information that exists on a topic, it is slanted more towards what is strange/interesting/controversial/trendy. This also includes such information available on the internet. There is a lot of great information to be found on the internet, but your best bet is to find out what is best for YOU from a trained health professional, such as your naturopathic doctor.
Comments
Since when did natural become the alternative?
20/12/10 10:25
Check out this blog by my colleague Ashley Mayer that asks the question “since when did natural become the alternative?”
I had to share this blog because it addresses a major shift in perception that has happened in society in a short period of time. Somehow in just a generation or two, most people have accepted advertising messages/manipulation that tells us that fake, altered, and lab-created foods are somehow equal to or even better than what nature has to offer. Although I have yet to read both of the Michael Pollan books I own, I know that one of his major messages is “eat food.” Even just sticking to this basic advice, meaning eat things in as close to their natural state as possible (unprocessed and free of preservatives, additives, flavours, colours, etc), would greatly benefit most people.
In this blog, Ashley addresses this question as well as the key points of: choose your sources of information carefully and employ your critical thinking skills to decide what is actually “healthy.”
I had to share this blog because it addresses a major shift in perception that has happened in society in a short period of time. Somehow in just a generation or two, most people have accepted advertising messages/manipulation that tells us that fake, altered, and lab-created foods are somehow equal to or even better than what nature has to offer. Although I have yet to read both of the Michael Pollan books I own, I know that one of his major messages is “eat food.” Even just sticking to this basic advice, meaning eat things in as close to their natural state as possible (unprocessed and free of preservatives, additives, flavours, colours, etc), would greatly benefit most people.
In this blog, Ashley addresses this question as well as the key points of: choose your sources of information carefully and employ your critical thinking skills to decide what is actually “healthy.”
Calcium and vitamin D
06/12/10 12:39
A recent article in the New York Times questioned the need for high levels of calcium and vitamin D supplementation that has become the new norm. I have already had patients ask me about this, so I will try to address it here.
I am always in favour of obtaining nutrients the way human beings were designed to get them, which is through food. Calcium and vitamin D are actually quite different types of nutrients, so I will discuss them separately. The main take-home point of this blog is that ultimately we are all unique and the beauty of naturopathic medicine is that as an ND I am able to work with you individually to assess your needs and make a recommendation that is personalized to you as an individual. So ultimately, to figure out how much calcium and vitamin D you should or should not take, talk to your naturopathic doctor!
Calcium
I am asked quite often how much calcium we need, what is the best source, etc... Osteoporosis is far too common in western society and yet we get lots of calcium here too! What’s going on? The short answer is that there is so much more to bone health than just calcium. There are three things to look at with regard to bone health.
First, the raw material needed to create bone. Calcium is just one of many building blocks necessary to make bone but it is definitely not the only one! Magnesium, phosphate, boron, and other minerals are all necessary.
Second, a pile of bricks does not make a house just as lots of materials (calcium and other minerals) do not automatically make bone. Bone has to be built and weight bearing exercise is a key factor to signal our bodies to take those materials and do something with them. When more stress is applied to bone, it becomes stronger. There are also other factors in building bone, such as proper blood flow (yes, bone is living tissue and needs blood!) and other signals like vitamin D (see below!) going on in the body.
Finally, we must prevent our bodies from breaking down bone to use those materials elsewhere. This is another complex area but in a nutshell, if your body needs some calcium to buffer your blood to keep it at the perfect pH level (which keeps you alive, by the way), it will draw this from bones. An acidic environment in our tissues increases the need to use bone to balance pH. And what causes an acidic environment? Stress, lack of sleep, caffeine/alcohol, sugar, dairy, and other acidifying foods...
While dairy groups and marketing boards have done an amazing job convincing people they need to eat a lot of servings of dairy products each day to get enough calcium, there are many other great sources of calcium that most people overlook. One great way is to make bone broth! You can also get calcium from leafy green veggies, nuts and seeds, and many other diverse food sources. For more info, check out the World’s Healthiest Foods site listing for calcium.
Vitamin D
In the case of vitamin D, our bodies use cholesterol (it’s not all bad!) to make vitamin D when our skin is exposed to the sun. For example, a caucasian person out in summer sun in just a bathing suit until his or her skin just begins to turn pink produces between 10,000 and 50,000IU of vitamin D. Vitamin D is a fat soluble vitamin and can therefore be stored by our bodies so that we can make it through winter off the supply we’ve built up in the summer. Lighter skinned people make more vitamin D from the sun so it’s no surprise that at higher latitudes you find blonder, paler people and near the equator (where there is more direct sun exposure and no long, dark winter) you find darker skinned people. Anyway, before there were ever vitamin D supplements, humans spent much of their time, particularly in the summer, outside and likely made enough vitamin D to last through each winter.
However, this is not the world we live in anymore! Unfortunately most people spend nearly all their time indoors during the day and therefore cannot make vitamin D from sun exposure. This alone is a powerful argument for supplementation, not to mention the greater issue of how our incredibly unnatural lifestyle impacts our health, but that is a topic for another day. In addition, there have been many studies on vitamin D in the past few decades demonstrating how vitamin D impacts so much more than bone health. Vitamin D is in fact a hormone, a key signalling system in the body that can impact all kinds of conditions. There are far too many studies for me to summarize here, but if you want to learn more, you can start with reading the response to the article linked above written by the Executive Director of the Vitamin D Council.
So how do you know what to do? Again, the best way to determine if supplementation is right for you and how much to supplement is to see a naturopathic doctor who can assess your unique situation. You can also ask your doctor to run a blood test for 25-hydroxy vitamin D. The province of Ontario has recently put more restrictions on this test because it became so popular but if you have a condition for which vitamin D is important or that puts you at greater risk for deficiency, such as osteoporosis, parathyroid disease, pregnancy, or kidney disease, speak to your doctor about testing your levels.
I am always in favour of obtaining nutrients the way human beings were designed to get them, which is through food. Calcium and vitamin D are actually quite different types of nutrients, so I will discuss them separately. The main take-home point of this blog is that ultimately we are all unique and the beauty of naturopathic medicine is that as an ND I am able to work with you individually to assess your needs and make a recommendation that is personalized to you as an individual. So ultimately, to figure out how much calcium and vitamin D you should or should not take, talk to your naturopathic doctor!
Calcium
I am asked quite often how much calcium we need, what is the best source, etc... Osteoporosis is far too common in western society and yet we get lots of calcium here too! What’s going on? The short answer is that there is so much more to bone health than just calcium. There are three things to look at with regard to bone health.
First, the raw material needed to create bone. Calcium is just one of many building blocks necessary to make bone but it is definitely not the only one! Magnesium, phosphate, boron, and other minerals are all necessary.
Second, a pile of bricks does not make a house just as lots of materials (calcium and other minerals) do not automatically make bone. Bone has to be built and weight bearing exercise is a key factor to signal our bodies to take those materials and do something with them. When more stress is applied to bone, it becomes stronger. There are also other factors in building bone, such as proper blood flow (yes, bone is living tissue and needs blood!) and other signals like vitamin D (see below!) going on in the body.
Finally, we must prevent our bodies from breaking down bone to use those materials elsewhere. This is another complex area but in a nutshell, if your body needs some calcium to buffer your blood to keep it at the perfect pH level (which keeps you alive, by the way), it will draw this from bones. An acidic environment in our tissues increases the need to use bone to balance pH. And what causes an acidic environment? Stress, lack of sleep, caffeine/alcohol, sugar, dairy, and other acidifying foods...
While dairy groups and marketing boards have done an amazing job convincing people they need to eat a lot of servings of dairy products each day to get enough calcium, there are many other great sources of calcium that most people overlook. One great way is to make bone broth! You can also get calcium from leafy green veggies, nuts and seeds, and many other diverse food sources. For more info, check out the World’s Healthiest Foods site listing for calcium.
Vitamin D
In the case of vitamin D, our bodies use cholesterol (it’s not all bad!) to make vitamin D when our skin is exposed to the sun. For example, a caucasian person out in summer sun in just a bathing suit until his or her skin just begins to turn pink produces between 10,000 and 50,000IU of vitamin D. Vitamin D is a fat soluble vitamin and can therefore be stored by our bodies so that we can make it through winter off the supply we’ve built up in the summer. Lighter skinned people make more vitamin D from the sun so it’s no surprise that at higher latitudes you find blonder, paler people and near the equator (where there is more direct sun exposure and no long, dark winter) you find darker skinned people. Anyway, before there were ever vitamin D supplements, humans spent much of their time, particularly in the summer, outside and likely made enough vitamin D to last through each winter.
However, this is not the world we live in anymore! Unfortunately most people spend nearly all their time indoors during the day and therefore cannot make vitamin D from sun exposure. This alone is a powerful argument for supplementation, not to mention the greater issue of how our incredibly unnatural lifestyle impacts our health, but that is a topic for another day. In addition, there have been many studies on vitamin D in the past few decades demonstrating how vitamin D impacts so much more than bone health. Vitamin D is in fact a hormone, a key signalling system in the body that can impact all kinds of conditions. There are far too many studies for me to summarize here, but if you want to learn more, you can start with reading the response to the article linked above written by the Executive Director of the Vitamin D Council.
So how do you know what to do? Again, the best way to determine if supplementation is right for you and how much to supplement is to see a naturopathic doctor who can assess your unique situation. You can also ask your doctor to run a blood test for 25-hydroxy vitamin D. The province of Ontario has recently put more restrictions on this test because it became so popular but if you have a condition for which vitamin D is important or that puts you at greater risk for deficiency, such as osteoporosis, parathyroid disease, pregnancy, or kidney disease, speak to your doctor about testing your levels.
A tastier flu "shot"
24/11/10 15:51
One of my favourite immune supporting tips is using berries to prevent colds and flu! Not only do they taste great, but they are also effective in strengthening immunity during the winter season.
Blueberries and other dark-coloured berries contain anthocyanidins, which can enter the cell wall of bacteria and slow growth and reproduction. They are also a good source of vitamin C and and are high in antioxidants, which support the immune system against both bacteria and viruses. Add berries to your smoothie (see my favourite recipe here) or into oatmeal as part of your breakfast.
Elderberry is particularly effective against influenza and other viral infections, such as the common cold. A quick search on PubMed reveals that elderberry extract offers an efficient, safe and cost-effective treatment for influenza and elderberry extract has been found to inhibit H1N1 infection in vitro.
There are a lot of liquid elderberry extracts on the market these days (including Sambucol and Sambu Guard) but make sure to read the ingredients because some contain added sugar, which actually impairs white blood cells and reduces your immune response! This is kind of counter-productive, don’t you think? Plus, elderberry and other berries taste great on their own, there is no reason to add extra sugar. Make sure you read labels! My personal favourite is Proberry liquid, which is a mixture of elderberry, blueberry, cherry, raspberry, and pear juice concentrates. Many of the elderberry concentrates come in capsule form too, which helps avoid the additives and can be more convenient to carry with you, so check these out too.
Blueberries and other dark-coloured berries contain anthocyanidins, which can enter the cell wall of bacteria and slow growth and reproduction. They are also a good source of vitamin C and and are high in antioxidants, which support the immune system against both bacteria and viruses. Add berries to your smoothie (see my favourite recipe here) or into oatmeal as part of your breakfast.
Elderberry is particularly effective against influenza and other viral infections, such as the common cold. A quick search on PubMed reveals that elderberry extract offers an efficient, safe and cost-effective treatment for influenza and elderberry extract has been found to inhibit H1N1 infection in vitro.
There are a lot of liquid elderberry extracts on the market these days (including Sambucol and Sambu Guard) but make sure to read the ingredients because some contain added sugar, which actually impairs white blood cells and reduces your immune response! This is kind of counter-productive, don’t you think? Plus, elderberry and other berries taste great on their own, there is no reason to add extra sugar. Make sure you read labels! My personal favourite is Proberry liquid, which is a mixture of elderberry, blueberry, cherry, raspberry, and pear juice concentrates. Many of the elderberry concentrates come in capsule form too, which helps avoid the additives and can be more convenient to carry with you, so check these out too.
Breast health and cancer prevention: nutrition
11/11/10 08:01
In October (breast cancer month) JD Kato and I did a presentation at a local library about breast health and cancer prevention. Here is a summary of some of the more interesting information we shared. Naturopathic medicine has an important role to play in cancer prevention and treatment. One of the most often used naturopathic treatments is dietary change because diet is the most powerful factor in health. You literally are what you eat! So here is an overview of WHY diet is so important to cancer and some examples of dietary choices that will help treat and prevent cancer.
Immune system:
Your immune system is your best defence against cancer. Every day, all day, your body is making potentially cancerous cells and it is your immune system that stands between this potential and uncontrollable cancer growth. A healthy diet provides nutrients that support immune function, while poor dietary choices impair immune function.
Antioxidant-rich foods support the immune system in killing abnormal cells, preventing and treating cancer. Sugar, on the other hand, impairs the activity of your white blood cells, which target and kill cancer cells and coordinate the functioning of your overall immune response.
Inflammation:
As discussed in part 1, chronic inflammation in the body leads to increased cell division, which increases the likelihood of the creation of cancer cells and accelarates cancer growth. Chronic inflammation also increases the body’s production of cortisol, which is an immune suppressing hormone.
What type of fat you consume is often more important than the amount because the fats in your diet directly impact many bodily functions. The compounds EPA and DHA derived from or found in omega 3 fatty acids, particularly fish oil, are powerful anti-inflammatory agents in the body. But saturated fats increase inflammation and trans fats alter cell membranes to encourage inflammation.
Hormonal balance:
The endocrine system, which produces and controls hormones throughout the body has a huge impact on physiological function. Hormones can encourage cancer growth as well as influence immune function and regulate inflammation. With regard to breast cancer, we know that some types of breast cancer are estrogen dependent, but many other hormones throughout the body also relate to breast cancer, such as thyroid hormones, insulin, and cortisol.
Green leafy vegetables contain nutrients that support endocrine organs. A minimum of 5-6 servings per day is recommended. Cruciferous vegetables in particular contain compounds called calcium-D-glucarate and indole-3-carbinol which aid in metabolism and detoxification of hormones. Pesticides used on non-organic produce can contain compounds that mimic estrogen in the body and can increase the risk of many types of cancer as well as overwhelm your detoxification system.
You can download the Environmental Working Group’s Shopper’s Guide to Pesticides, which specifies which produce is best to buy organic, at this web address: www.foodnews.org
Insulin resistance:
Insulin is a hormone that allows sugar to enter cells. Over time, high sugar intake leads to excess insulin production and eventually cells become insensitive to insulin. Cancer cells use sugar as fuel and have more insulin receptors than normal cells, so while other cells are insulin resistant, cancer cells can gain more access to sugar.
Complex carbs include vegetables and whole grains and can help balance blood sugar levels and control weight, both of which prevent and reduce insulin resistance. Complex carbs are high in fibre, which binds to and eliminates toxins and hormones from your body. Try to eat foods as close to their natural state as possible rather than processed foods, which contain more simple carbs, which are easily reduced to sugar and therefore promote insulin resistance.
Digestion and elimination:
Digestion influences all other bodily functions as it is key to absorbing essential nutrients and eliminating waste products and toxins from the body.
Alcohol is an example of a substance that places an additional load on the liver, which can lead to increased toxic load in the body. Over time, this can damage cells and encourage cancer formation. Adequate water intake is necessary for optimal digestion and elimination as your body uses water to carry out many processes essential for life. A simple guideline for water intake is at least 1/2 ounce of water per pound of body weight. So a 128-pound woman should drink about 64 ounces of water daily, which is about 2 litres. Caffeine and alcohol do not count toward this intake and in fact dehydrate the body!
Beyond diet:
So far we’ve covered a lot with regard to diet, but there is so much more! As a naturopathic doctor, I work with patients to address their unique nutritional needs with a plan tailored to them. Beyond diet, I also work to create a personalized plan that may include supplements, herbs, lifestyle counselling, stress reduction, and mental/emotional work to address each patient’s unique needs and the root causes behind their health specific concerns.
With regards to cancer, naturopathic medicine is a powerful tool to both prevent and treat cancer, either alone or in conjunction with conventional cancer treatment.
Immune system:
Your immune system is your best defence against cancer. Every day, all day, your body is making potentially cancerous cells and it is your immune system that stands between this potential and uncontrollable cancer growth. A healthy diet provides nutrients that support immune function, while poor dietary choices impair immune function.
Antioxidant-rich foods support the immune system in killing abnormal cells, preventing and treating cancer. Sugar, on the other hand, impairs the activity of your white blood cells, which target and kill cancer cells and coordinate the functioning of your overall immune response.
Inflammation:
As discussed in part 1, chronic inflammation in the body leads to increased cell division, which increases the likelihood of the creation of cancer cells and accelarates cancer growth. Chronic inflammation also increases the body’s production of cortisol, which is an immune suppressing hormone.
What type of fat you consume is often more important than the amount because the fats in your diet directly impact many bodily functions. The compounds EPA and DHA derived from or found in omega 3 fatty acids, particularly fish oil, are powerful anti-inflammatory agents in the body. But saturated fats increase inflammation and trans fats alter cell membranes to encourage inflammation.
Hormonal balance:
The endocrine system, which produces and controls hormones throughout the body has a huge impact on physiological function. Hormones can encourage cancer growth as well as influence immune function and regulate inflammation. With regard to breast cancer, we know that some types of breast cancer are estrogen dependent, but many other hormones throughout the body also relate to breast cancer, such as thyroid hormones, insulin, and cortisol.
Green leafy vegetables contain nutrients that support endocrine organs. A minimum of 5-6 servings per day is recommended. Cruciferous vegetables in particular contain compounds called calcium-D-glucarate and indole-3-carbinol which aid in metabolism and detoxification of hormones. Pesticides used on non-organic produce can contain compounds that mimic estrogen in the body and can increase the risk of many types of cancer as well as overwhelm your detoxification system.
You can download the Environmental Working Group’s Shopper’s Guide to Pesticides, which specifies which produce is best to buy organic, at this web address: www.foodnews.org
Insulin resistance:
Insulin is a hormone that allows sugar to enter cells. Over time, high sugar intake leads to excess insulin production and eventually cells become insensitive to insulin. Cancer cells use sugar as fuel and have more insulin receptors than normal cells, so while other cells are insulin resistant, cancer cells can gain more access to sugar.
Complex carbs include vegetables and whole grains and can help balance blood sugar levels and control weight, both of which prevent and reduce insulin resistance. Complex carbs are high in fibre, which binds to and eliminates toxins and hormones from your body. Try to eat foods as close to their natural state as possible rather than processed foods, which contain more simple carbs, which are easily reduced to sugar and therefore promote insulin resistance.
Digestion and elimination:
Digestion influences all other bodily functions as it is key to absorbing essential nutrients and eliminating waste products and toxins from the body.
Alcohol is an example of a substance that places an additional load on the liver, which can lead to increased toxic load in the body. Over time, this can damage cells and encourage cancer formation. Adequate water intake is necessary for optimal digestion and elimination as your body uses water to carry out many processes essential for life. A simple guideline for water intake is at least 1/2 ounce of water per pound of body weight. So a 128-pound woman should drink about 64 ounces of water daily, which is about 2 litres. Caffeine and alcohol do not count toward this intake and in fact dehydrate the body!
Beyond diet:
So far we’ve covered a lot with regard to diet, but there is so much more! As a naturopathic doctor, I work with patients to address their unique nutritional needs with a plan tailored to them. Beyond diet, I also work to create a personalized plan that may include supplements, herbs, lifestyle counselling, stress reduction, and mental/emotional work to address each patient’s unique needs and the root causes behind their health specific concerns.
With regards to cancer, naturopathic medicine is a powerful tool to both prevent and treat cancer, either alone or in conjunction with conventional cancer treatment.